Citation Nr: 0000570
Decision Date: 01/07/00 Archive Date: 01/11/00
DOCKET NO. 97-33 017A ) DATE
)
)
On appeal from the
Department of Veterans Affairs Regional Office in
Indianapolis, Indiana
THE ISSUE
Entitlement to an increased rating for residuals of excision
of pituitary adenoma, currently evaluated at 30 percent.
ATTORNEY FOR THE BOARD
Edward Walls, Associate Counsel
INTRODUCTION
The veteran served on active duty from January 1981 to
January 1985. His appeal comes before the Board of Veterans'
Appeals (Board) from an April 1997 rating decision of the
Department of Veterans Affairs (VA) Regional Office (RO) in
Indianapolis, Indiana.
REMAND
The veteran has contended that the evaluation assigned for
his pituitary adenoma inadequately reflects the severity of
his symptomatology. The RO in its April 1997 rating decision
evaluated the veteran's pituitary adenoma analogous to
acromegaly under Diagnostic Code (DC) 7908, and his
disability was evaluated at 30 percent.
A March 1997 VA pituitary tumors examination report reflects
that the veteran denied that he had diabetes, heart disease,
eye problems, and a history of high blood pressure or rectal
bleeding. On physical examination, he was six feet seven
inches tall. He did not have any significant frontal
bossing. His thyroid was normal. He had anicteric sclera,
and his conjunctiva was pink. His chest was clear to
auscultation. The record is absent of other contemporaneous
VA examinations regarding the veteran's pituitary adenoma.
In the veteran's May 1997 notice of disagreement he indicates
that he had been prescribed Atenolol. In a letter attached
to the veteran's November 1997 substantive appeal he appears
to indicate that he has been diagnosed with hypertension.
Hypertension is part of the criteria that may be considered
under Diagnostic Code 7908.
In light of the above the appeal is REMANDED for the
following development:
1. The RO should contact the veteran and
request that he identify the names,
addresses and approximate dates of
treatment for all health care providers
who may possess additional records
pertaining to any treatment for residuals
of excision of pituitary adenoma. After
obtaining any necessary authorization(s)
from the veteran, the RO should attempt
to obtain and associate with the claims
file any medical records identified which
have not been secured previously.
2. The RO should arrange for the veteran
to be given a VA medical examination to
determine the nature and extent of his
residuals of excision of pituitary
adenoma. All specialized testing should
be completed as deemed necessary by the
examiner. The examiner should expressly
state an opinion as to whether there is
evidence of increased intracranial
pressure (such as visual field defect),
arthropathy, glucose intolerance, and
either hypertension or cardiomegaly. The
examiner should state whether there is
enlargement of acral parts or overgrowth
of long bones, and enlarged sella
turcica. Since it is important "that
each disability be viewed in relation to
its history[,]" 38 C.F.R. § 4.1 (1999),
copies of all pertinent medical records
in the veteran's claims file or, in the
alternative, the claims file, must be
made available to the examiner for
review.
3. Next, the RO must review the
examination report to ensure that it is
in complete compliance with the
directives of this REMAND, and, if not,
the RO should implement corrective
procedures.
4. When the development requested has
been completed, the case should again be
reviewed by the RO on the basis of the
additional evidence. If the benefit
sought is not granted the appellant
should be furnished a Supplemental
Statement of the Case. He should be
afforded the appropriate opportunity to
respond before the record is returned to
the Board for further review.
The purpose of this REMAND is to obtain additional
development, and the Board does not intimate any opinion as
to the merits of the case, either favorable or unfavorable,
at this time. The appellant is free to submit any additional
evidence and/or argument he desires to have considered in
connection with his current appeal. No action is required of
the appellant until he is notified.
MILO H. HAWLEY
Acting Member, Board of Veterans' Appeals
Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United States
Court of Veterans Appeals. This remand is in the nature of a
preliminary order and does not constitute a decision of the
Board on the merits of your appeal. 38 C.F.R. § 20.1100(b)
(1999).